Fibromyalgia and Chiropractic

"Fibromyalgia is defined as a chronic, generalized pain condition associated with symptoms of fatigue, stiffness, and sleep disturbance and is characterized by the physical findings of local tenderness in many specific but widely dispersed sites. Fibromyalgia is the most common cause of widespread pain. The prevalence of this disorder in the general population is between 3% and 5%... Most patients with fibromyalgia remain symptomatic for several years, and no cure has been identified."

The authors of this study set out to see if chiropractic could help patients with fibromyalgia. The study included fifteen women who had suffered from fibromyalgia symptoms an average of 10 years. Each participant was examined for trigger points and was asked to fill out a pain questionnaire. The subjects underwent treatment 2 to 3 times a week, with a total of 30 treatments. The treatment consisted of "applying ischemic compression to a number of tender points" and spinal manipulation of the cervical and thoracic spine.

The subjects filled out a second pain questionnaire after 15 treatments, a third after 30 treatments, and a fourth one month after the completion of treatment. The authors determined that a 50% reduction in pain would be necessary to consider a patient a "respondent" to treatment.

"A total of 9 (60%) subjects were classified as respondents and 6 (40%) as nonrespondents based on their percent improvement rating in pain intensity after the 30th treatment. There was no statistically significant difference between the baseline characteristics of the two groups. However, some clinically significant trends were noted. Nonrespondents were apparently older with more severe and chronic pain and a higher number of tender points."

The reduction in pain and symptoms that the respondents reported was significant:

Pain intensity dropped 77.1%.

Sleep was enhanced 63.5%.

Fatigue levels dropped 74.8%.

Furthermore, the patients retained the improvement at the one-month follow-up.

The authors conclude: "This study suggests a potential role for chiropractic care in the management of fibromyalgia. Most subjects with fibromyalgia appear to have responded with favorably to a course of 30 chiropractic treatments including spinal manipulation and ischemic compression therapy. Fifteen treatments seem to be an adequate cutoff point to determine if a significant improvement in pain has occurred and if further care is warranted."

Hains G, Hains F. Combined ischemic compression and spinal manipulation in the treatment of fibromyalgia: a preliminary estimate of dose and efficacy. Journal of Manipulative and Physiological Therapeutics 2000;23(4):225-230.